Genensky/Foley Magnification Award 2026

Genensky-Foley Magnification Award 2026

Please provide the information requested below; all questions must be answered thoroughly. Your answers will help the committee determine your status within our selection processes. Also please review your personal information prior to submitting you’re application to ensure your contact information is accurate.

1. Applicant’s Personal Information:

Name (First and Last)(Required)

Enter your First and Last Name here.

Street Address(Required)

Enter your Street Address here.

P. O. Box or Apartment

If you have a P.O. Box or Apartment enter it here.

City(Required)

State(Required)

Zip Code(Required)

Phone Number(Required)

Enter your Phone Number here.

Email(Required)

Enter your Email Address here.

Date of Birth(Required)

2 Vision:

How long have you been visually impaired?(Required)

Are you legally blind?(Required)

Please respond Yes or No.

What is the cause of your visual impairment?(Required)

What is your visual acuity?(Required)

3. Education:

Are you a High School graduate?(Required)

Are you currently a student?(Required)

Please respond Yes or No.

What is the last grade, degree, or year completed at the time of submission of this application?(Required)

4. Occupation:

Are you currently employed?(Required)

Please respond Yes or No.

If you are employed, do you work full or part time?

If you are currently employed, What is your job title?

Do you volunteer?(Required)

Please respond Yes or No.

If you volunteer, what kind of volunteer work do you do?(Required)

5. Financial Information:

Do you receive SSI, SSDI, or other government assistance?(Required)

If you are a student, are you receiving financial aid?

6. Technology:

What devices are you currently using to accomplish daily tasks?(Required)

If you are using magnification devices to perform daily tasks, how do they help you?(Required)

Have you received help in obtaining devices of any kind in the past? If so, please explain?(Required)

In a few sentences, please explain how obtaining a magnification device from CCLVI would provide you with technology you may not be able to afford.(Required)

In a few sentences, please explain what type of magnification device would help you best and how it will enhance your ability to perform daily tasks.(Required)

Please explain how you utilize your functional vision during a typical day.(Required)

7. Miscellaneous:

How did you hear about the Genensky-Foley Award?(Required)

Are you a member of CCLVI?

Please respond Yes or No.

If not, are you interested in becoming a member or receiving information from us?

Please share any additional information you believe might be helpful for the committee to know in evaluating your application.(Required)

8. If you are filling this application out for someone else, please provide the information below.

Name (First and Last)

Street Address

P.O. Box or Apartment

Enter the P.O. Box or Apartment Number here.

City

State

Zip Code

Phone Number

Relationship to applicant.